What kind of exercise is safe for lymphedema?

January 15, 2021

What kind of exercise is safe for lymphedema?

You may have received instructions from your medical team on whether exercise may be safe for you and your specific stage of treatment and degree of edema. It is best to follow this advice. If you feel encouraged to start exercising or change your approach to exercise after reading this article, please discuss it with your medical team first.

In the past, individuals with lymphedema or those at-risk to develop it have generally been advised against exercising the limb and were recommended to limit affected limb mobility. Even tasks such as carrying a baby, bringing in groceries, or shoveling the snow were off the table. It was believed that these factors contributed to the onset and development of lymphedema. Recent studies have shown that exercising while wearing a well-fitted medical compression garment, is not only safe but can actually help reduce the severity or onset of swelling.

Resistance Training

A 2009 study has concluded that controlled weight-lifting is safe for women with breast-cancer-related lymphedema, and not only is it safe, but it can actually be effective in reducing lymphedema severity. The study found that the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms in comparison to the control group. Exercises were progressive in intensity and under the supervision of a therapist, patients were wearing well-fitted medical graduated compression garments for the duration of the exercise.

While the study cited above focused on weight-lifting, it is not the only type of resistance training that can be beneficial for lymphedema. Other forms of resistance training include bodyweight exercises (such as push-ups), exercises using suspension equipment (such as TRX), and exercises using resistance bands that provide continuous resistance with each movement. In addition to keeping lymphedema in-check, there are also other benefits of resistance training such as increased bone density, maintaining weight loss, increased joint mobility, reduced fatigue, reduced incidence of depression, improved self-image, and a better quality of life.

Cardiovascular Training/Aerobic Exercise

If you are working with a lymphedema therapist, they may have recommended lymphedema specific exercises, these are likely cardiovascular exercises. Cardiovascular exercise is an important component of Complex Decongestive Therapy (CDT) a standard in lymphedema treatment. Unlike the vascular system, the lymphatic system does not have a pump to help circulate fluid, so we are reliant on movement to keep lymphatic fluid from stagnating. Cardiovascular exercise works to improve lymphedema by increasing the movement of the lymphatic fluid. Cardiovascular exercise can be localized, meaning just moving the affected limb up and down or side to side, or it can be a full-body exercise such as running, cycling, paddling (Dragon boating), or swimming. Any exercise where you are increasing your heart rate by moving your body and increasing the exchange of oxygen in the bloodstream by moving your body, you are also increasing the circulation of lymphatic fluid, which keeps lymph from stagnating and may reduce the severity of swelling. As with resistance exercises, a well fitted medical graduated compression garment should be worn when performing cardiovascular exercises. In addition to potentially reducing swelling, other benefits of cardio include reduced chronic pain, maintaining a healthy weight, lower blood pressure, and strengthening the immune system.

Yoga & Deep Diaphragmatic Breathing

If performed correctly, and gently, yoga can benefit the whole body and is safe to do for those with lymphedema. Yoga focuses on repetitive rhythmic movements which can help move stagnant lymphatic fluid, although modifications may need to be made for certain poses that put undue stress on the affected area/limb(s). Many different types of yoga are safe for lymphedema, however, one exception is hot yoga. The high heat of a hot yoga room can increase capillary pressure and therefore increase edema, it is best to stay away from this type of yoga, or any exercise that relies on a very hot environment to be performed. If you’re starting a new yoga practice be sure to discuss your lymphedema with your trainer so certain exercises may be modified.

Deep diaphragmatic breathing can be done independently or as part of your yoga or meditation practice. Deep diaphragmatic breathing stimulates the lymphatic system, increases lymphatic flow, and can help alleviate lymphatic congestion. The up and down movement of the diaphragm during deep breathing aids the return of lymphatic fluid back to the bloodstream. The video below demonstrates how to do this kind of exercise for lymphedema patients.

Be Kind to Yourself

It is now widely accepted that it is safe for individuals with lymphedema or at-risk to exercise the affected limb(s). The most important thing to remember when embarking on a new exercise program is that it’s important to not over-do it. Speak with your medical team about adding exercise to your routine, tell them about the type of exercise you’re interested in adding, and ask for guidance on how to perform it safely. If you’ve never lifted weights before, work with a professional that is well-versed in lymphedema care and resistance training to develop a progressive program to increase strength over time. If you’re curious about trying yoga and have breast cancer-related lymphedema, look for a Yoga 4 Cancer certified instructor. If you haven’t gone for a run in years, don’t set out to run a 5K on the first run back. Overall, overdoing it can lead to injuries in anyone but injuries on the lymphedema affected limb can be a major setback. It is better to progressively increase your practice and enjoy your process than to burn out immediately and injure yourself. As a rule of thumb, wearing a well-fitted medical compression garment is advised when exercising.

The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding lymphedema. Never disregard professional medical advice or delay in seeking it because of something you have read on the internet.